In the past few weeks, USICH (US Interagency Council on Homelessness) released its six-month COVID-19 report. We thought it would be of value to break it down as future pandemic planning is beginning. USICH's primary objective was to "save lives and avoid overwhelming local emergency rooms and departments due to medically compromised residents of homelessness facilities and encampments." USICH has worked directly with a multitude of federal agencies and direct front-line homeless service providers. To individualize its response USICH, split the homeless community into four sub-cohorts: People receiving homelessness-based housing vouchers, people living in emergency centers, shelters, and campuses, people living in encampments, and students, unaccompanied youth or families with children experiencing homelessness.
For the first sub-cohort, USICH implemented CDC guidance specific to shared and congregate housing. The second sub-cohort was a priority area for USICH. The first step USICH recommended was to verify possible transmission from staff. Following this, the primary guidance was to wear masks, social distance at least six-feet, isolate, and quarantine as needed, eliminate congregate meals, increase disinfection, and implement "location tracing." The third sub-cohort had different needs from the other groups because the "risk of transmission is generally lower due to outdoor airflow, UV rays, and a general aversion to interaction." Those living in encampments were given CDC guidance that focused on improved sanitation, as well as the discouragement of removing individuals from the encampments. The fourth sub-cohort needed an increase of connection to services because many of the individuals have experienced domestic violence and abuse, as well as having higher food insecurity.
USICH also reported that "Those who were particularly hit were, Individuals and families experiencing homelessness require specific attention due to instances of relatively higher medical acuities that increase the risk of bad outcomes. Communities of color suffer relatively more from underlying chronic health conditions, such as diabetes, hypertension, obesity, and chronic kidney disease, that are negatively affected after contracting COVID-19. Additionally, data show health disparities when it comes to Black, Latinx, Native American, and other communities of color, including families and individuals experiencing homelessness."
In the effort to mitigate the spread of COVID-19 within communities experiencing homelessness USICH, lead collaborative initiatives to connect local service providers with CDC guidance. This included the dissemination of information as well as providing manpower. A lot of this work manifested in the form of webinars that chronicled homeless spots from hotspots like Seattle and King County, Washington, and Los Angeles County. USICH also made their network available to homeless service providers, which allowed for 96.8% of the emergency beds in the United States to be represented.
USICH has also been collecting COVID-19 data from around the country to provide an accurate representation of the spread and services needed. According to the report, " local affiliates report a 25-75% increase in demand for services." Meal and food services represent the highest increase. This increase in demand for services lead to additional operational costs for food, PPE, cleaning supplies, and linens.
USICH reports that "As of June 30, 2020, there have been 4,845 positive COVID-19 cases and 130 deaths." The number of positive cases is lower than originally predicted. This is likely due to the collaborative nature of the USICH response. In most local communities, homeless individuals have been tested at a significantly higher rate than the general public. Nationally, there have been only nine local communities to report more than 100 confirmed positive cases of COVID-19 within the homeless community. To its initial goal of reducing emergency room visits, USICH reports that during the last eight weeks the emergency room and department visit percentage rate has dropped seven of the last eight weeks on a week-over-week basis for individuals experiencing homelessness.
The remainder of the USICH report outlines future COVID-19 planning as it coincides with the flu season. They believe that the best way to fight these "two-front wars" is to widely administer the season flu vaccine within the homeless community, which will act as a great pilot for the eventual COVID-19 vaccine. USICH will be focusing on families and youth experiencing homelessness, as economic strain and at-home school created added pressure. They will be designated specific resources to increased accessibility to wrap-around services for these individuals. USICH also emphasized the importance of relieving staff fatigue among homeless providers. They suggest that allocating resources to expand staff capacity would be extremely helpful for these efforts. The final recommendation from USICH for future pandemic planning is addressing the need for scalable and flexible isolation and quarantine areas and sites. This will be critical within areas that have community spread.
Sources: https://www.usich.gov/resources/uploads/asset_library/USICH_Covid_19_First_Six_Month_Report_FINAL.pdf